You’ve probably heard of psoriasis — nearly 8 million people in the United States alone suffer from it. But did you know there are different types? Perhaps one of the least known is a form known as guttate psoriasis, named for the distinct teardrop-shaped lesions that it causes, as “gutta” is Latin for “drop.” While guttate psoriasis makes up a very small percentage of psoriasis cases, its presentation and symptoms are no less troubling. (Source)

So, what exactly is guttate psoriasis? What causes it, and can you prevent it? If you have it, how do you treat it? Are there lifestyle modifications that can stop it from recurring? Keep reading to learn the answers to these questions and more! 

What Is Guttate Psoriasis?

Psoriasis, including guttate psoriasis, is classified as an autoimmune disease, which develops when the body’s immune system mounts an attack on its own healthy tissues. It’s this attack that results in the symptoms of the disease. Experts still aren’t exactly sure what causes this to happen, but it’s becoming clear that it’s a complex interplay between genetics, environment  — both internal and external, including diet, stress, and infections — and other health factors, such as an overactive immune system.

In the case of psoriasis, the skin bears the brunt of the attack, although depending on the type of psoriasis other organs and joints may be involved as well.

It normally takes new, healthy skin cells about a month from the time they’re formed at the bottom of the epidermis to migrate to the skin’s surface, where they replace older, dead skin cells. This process of new skin cells replacing old is called cell turnover. When someone is suffering from psoriasis, an overactive immune response accelerates this process to a matter of several days. The body can’t handle the excess amount of skin cells being produced, so thickened, scaly patches of skin — called plaques — result from the buildup. 

Guttate psoriasis is a rare form of psoriasis that most commonly appears in young people (children, teens, and young adults under 30) without warning, often after an illness. Unlike many other autoimmune conditions, guttate psoriasis appears to affect both genders equally. And as with all other forms of psoriasis, guttate psoriasis is not contagious and can’t be spread to others. (Source, Source, Source)

Causes of Guttate Psoriasis

Different things trigger psoriasis for different people. In the case of guttate psoriasis, a bacterial or viral infection often precedes its onset, most commonly an infection with a group A Streptococcus bacterium, such as strep throat, or an upper respiratory infection. Although rare, cases of guttate psoriasis have also been reported after a COVID-19 infection, caused by the SARS-CoV-2 virus. In these cases, guttate psoriasis often appears 1 or 2 weeks after illness onset. This type of presentation is known as acute guttate psoriasis. Acute occurrences often resolve within a few weeks and may never come back.

Guttate psoriasis may also appear in people with existing chronic plaque psoriasis, resulting in a “guttate flare” on top of the chronic psoriatic condition. It’s also possible for guttate psoriasis to progress into chronic plaque psoriasis, which can then morph into other forms of the skin condition. That happens in around one third of patients. It’s unclear what causes it to completely clear up in some people, yet turn chronic in others.

In addition to infections, the following can sometimes also trigger this rare form of psoriasis:

• skin wounds resulting from insect bites, cuts, or burns
• excessive amounts of alcohol or stress
• sunburns
• certain medications, including TNF-alpha inhibitors, beta blockers, lithium, and antimalarial drugs

Guttate psoriasis can also be genetic, meaning if one of your parents or someone in your family has it, you’re more likely to suffer from it as well. People with weakened immune systems may also be more susceptible to all types of psoriasis. (Source, Source, Source)

Symptoms of Guttate Psoriasis 

Guttate psoriasis often catches people by surprise, appearing without warning. Thankfully, in many cases, it disappears just as mysteriously as it appeared, usually within several weeks of onset.

The telltale, teardrop-shaped skin lesions of guttate psoriasis are typically small (10 mm wide or less), round spots that are pinkish-red in color. They often appear on the arms and legs, but can also show up on the scalp, face, or ears, too. The bumps are usually raised and scaly, and might itch. 

People with this form of psoriasis may have only a few skin lesions, or may have over 100 that cover large amounts of their body. The lesions are well-defined, however, meaning even if they’re numerous they maintain borders, and healthy skin can be seen between the spots.

Because guttate psoriasis is often self-limiting, unless it develops into a chronic condition it doesn’t progress in stages as other forms of psoriasis can. (Source, Source)

‍

How is Guttate Psoriasis Diagnosed?

Guttate psoriasis is easily diagnosed by its signature appearance, particularly if it occurs after a bout with an upper respiratory infection or a bacterial infection such as strep throat.

A health care provider can also order a skin biopsy to confirm the diagnosis, if necessary. If strep throat is suspected, a throat culture may be ordered, too, or blood tests to see if there’s been a recent bacterial infection. (Source)

Treating Guttate Psoriasis

The good news? Guttate psoriasis usually responds well to several different treatment options that lessen skin inflammation, slow down the production of new skin cells, and reduce itchiness. If the attack follows a bacterial infection such as strep throat that doctors suspect is still active in the body, antibiotics may be prescribed. Other treatments can include:

• topical corticosteroid creams
• light therapy (ultraviolet, or UV, therapy)
• moisturizing creams and lotions that contain tar
• medicated shampoos
• vitamin D (applied topically) or vitamin A (taken orally)

Biologic therapies, derived from or based on biological materials, are not commonly used to treat acute, non-recurring episodes of guttate psoriasis. If it becomes chronic plaque psoriasis, biologics may be considered for long-term management. (Source, Source)

Lifestyle Modifications to Help Manage Psoriasis

As with other autoimmune disorders, psoriasis may be rooted in and made worse by certain lifestyle choices. Many types of foods, medications, skin products, high amounts of stress, alcohol, an unhealthy gut microbiome and — as is the case with guttate psoriasis — infections, can all trigger autoimmune disease in susceptible individuals.

To keep your immune system strong — and reduce inflammation in your body, thereby creating an internal environment that’s inhospitable to autoimmune issues — try the following:

• Identify your food sensitivities or allergies, and avoid those triggers. Elimination diets such as the autoimmune protocol (AIP) are a great place to start. Eat a nutrient-dense diet that’s rich in vegetables, fruits, high-quality protein, fermented foods, and “good fats,” while eliminating highly processed foods and sugar. Eating this way is important to balance your gut microbiome and hormones, which is essential for proper immune function.
• Prioritize sleep. Aim to get 7 to 9 hours of restorative sleep every night, and try to go to bed and wake up around the same time every day.
• Practice active relaxation. Stress hormones are highly inflammatory, and can disrupt health in a variety of ways. Find a relaxing activity you enjoy (like being in nature, taking walks, journaling, meditating, listening to music, etc.) and schedule it into your day.
• Move your body daily. Exercise is a great way to lower stress hormones and improve your cardiovascular health.
• Avoid toxins in your environment. It’s an unfortunate reality of modern life that we’re surrounded by toxins — in the food we eat, the air we breathe, the water we drink, and the products we use in everyday life. Some are unavoidable, but you can lessen your toxic load by filtering the air and water in your home, eating organic foods whenever possible, and choosing safer cleaning and beauty products from a database like the Environmental Working Group (EWG).

Bottom Line on Guttate Psoriasis

Guttate psoriasis, like all other types of psoriasis, is the result of a dysfunctional immune response. There are many different triggers for psoriasis but guttate psoriasis, which usually occurs in people under the age of 30, is most commonly preceded by a viral or bacterial infection. Sunburns, certain medications, alcohol, and other factors are sometimes also at play.

‍

Thankfully, for many people, guttate psoriasis disappears on its own after several weeks and may never come back. For others, however, it can progress into chronic plaque psoriasis. Topical treatments can soothe symptoms, and lifestyle modifications can help prevent disease progression. Reducing stress, getting enough sleep, eating a nutrient-dense diet, exercising, and balancing the gut microbiome are all important components of calming the body’s internal environment and quieting an overactive immune system.

WellTheory takes a comprehensive, whole-person approach to managing the symptoms of autoimmune disease, ensuring members reduce their symptoms and experience real relief.

‍